Principal investigator: Dr Andrew Norris, Nottingham University Hospitals Trust.
Project start year: 2017
Co-investigators: Professor Sergey Piletsky - University of Leciester. Dr Serhiy Korposh & Professor Steve Morgan - University of Nottingham.
Other partners: Prof Alexander Lanson, - University of Manchester; Dr Sanjukta Deb - King’s College London; Andrew Pritchard - B Braun Ltd.
Closed loop drug monitoring and delivery in intensive care
Survival in intensive care (IC) depends on having a comprehensive picture of a patient’s condition. Accurate continuous monitoring of vital parameters such as gas exchange, blood pressures and heart rate, temperature, ventilator mechanics, renal function, nutrition, and metabolism are available. However, continuous monitoring of drug levels is an unmet clinical need, the solving of which would provide a step change in IC practice and enable clinicians to provide optimised and individualized treatment of critically ill patients, with potential for reduced length of stay and of adverse events. Each patient day costs ~£1900.
Using novel optical chemical sensors, we propose to develop real-time blood level monitoring of sedative and analgesic drugs such as fentanyl, midazolam and propofol. This would enable precise and individualized monitoring of infusion rates or other dosing schedules to maintain continuously effective drug levels while minimizing adverse effects due to overdosage and accumulation. This is particularly important in drugs which have a narrow therapeutic window, or those with significant toxic side effects, for example, aminoglycosides and ciclosporin, if not administered correctly, can induce hearing loss and kidney failure.